体外循环阻断与不阻断冠脉循环瓣膜置换术的临床效果比较  

Comparison of clinical effects of cardiopulmonary bypass valve replacements with coronary circulation arrest or non-arrest

作　　者：李军朋[1] 王云[1] 侯小东[1] 顾继伟[1] 赵金超[1] 

机构地区：[1]宁夏医学院附属医院心胸外科,宁夏银川750004

出　　处：《心脏杂志》2008年第4期482-486,共5页Chinese Heart Journal

摘　　要：目的对比分析体外循环阻断与不阻断冠脉循环瓣膜置换术临床效果。方法182例患者分为阻断冠脉循环组(83例)和不阻断冠脉循环组(99例)。术前两组一般临床资料均衡。不阻断组采取不阻断升主动脉顺灌或阻断升主动脉从冠状静脉窦逆灌,保持心肌氧合血的持续灌注,在心脏停跳或不停跳下实施瓣膜置换术。术后比较两组呼吸、循环相关指标及各种心血管活性药物用量。结果不阻断组术后多巴胺、多巴酚丁胺、西地兰用量,机械辅助呼吸时间均小于阻断组(P<0.05)。结论体外循环不阻断冠脉循环瓣膜置换术有更好的心、肺保护效果。AIM To compare the clinical outcome of cardiopulmonary bypass （CPB） valve replacements with coronary circulation arrest or non-arrest. METHODS Included in the study were 182 patients, 83 of whom received valve replacements with coronary circulation arrest and 99 without coronary circulation arrest. There were no significant differences in the preoperative clinical data between the two groups. In the non-arrest group, the ascending aorta was not clamped, or clamped with coronary artery retrograde perfused from the vena coronary vein sinus, so as to maintain the blood supply to the myocardium. The postoperative data of breath, circulation and dosage of inotropes in the two groups were collected and compared. RESULTS In the non-arrest group, the dosage of inotropes and assisted respiration time were significantly less than those in arrest group （ P 〈 0. 05 ）. COCLUSION Valve replacements with no coronary circulation arrest are superior to that with coronary circulation arrest in heart and lung protection.

关 键 词：体外循环 冠状动脉循环 阻断 不阻断 瓣膜置换手术 

分 类 号：R542.5[医药卫生—心血管疾病]